Things You Should Know About Birth Control

We just lately requested members of the BuzzFeed Community to inform us questions they’d about contraception that they have been too scared to ask.

Then we spoke with Dr. Sophia Yen, MD, MPH, who’s an Associate Professor of Pediatrics within the Division of Adolescent Medicine at Stanford Medical School and CEO and Co-Founder of Pandia Health, to get her knowledgeable responses on these questions.

Maritsa Patrinos / BuzzFeed


“Can birth control pills render women infertile in the long run?” — zahra09h

Dr. Yen: “No. What it is, is that 10% of women have PCOS (Polycystic ovary syndrome). PCOS women will have a hard time getting pregnant. So if you put all women on birth control, and then take them off, you expect 10% of women to have a hard time getting pregnant. It is NOT because of the birth control, it’s because of the PCOS. Oddly enough, for PCOS women, sometimes being on the birth control (which normalizes their hormones) then coming off is when they are most fertile because that is when their hormones are most normal.”


“Can an IUD be punctured through the uterine wall if your partner/spouse has a large penis?” —loraafinley

Dr. Yen: No. Usually it occurs on insertion of the IUD by the practitioner. Or the practitioner caught it within the wall and the uterine contractions pushed it by way of. But not by penis.”


“Is there a ‘window’ of time for me to take my oral birth control? I know you have to take it at the same time every day for it to be effective, but what if I miss the mark by 15 minutes? Am I still OK?” —emilys44b743fcd

Dr. Yen: “If you are on the progesterone only pills, you have a 3 hour window. If you are 3 hours or more late, you need to use emergency contraception if you had sex within the past 5 days and use a backup method or abstain for the next 5 days (while you catch up). If you are on the ‘regular’ estrogen AND progesterone ‘combined’ pills, then there is a larger window. You can miss 1 pill and still be OK. 2 pills sometimes OK. But at 3 pills, definitely consider emergency contraception if you had sex within the past 5 days and use a backup method or abstain for the next 5 days (while you catch up).”


“Can birth control cause vivid or really weird dreams?” — preistessofsass

Dr. Yen: That is just not a reported facet impact, however something is feasible. Each individual is totally different and may reply otherwise to the medicine.”


“Is it possible that birth control isn’t right for me? I’m trying really hard to be safe but I’m getting so exhausted from having side effects.” —jordans4bf42d485

Dr. Yen: There is the IUD with hormone, the IUD with out hormone, the implant, the shot, the vaginal ring, the patch, then there are like 40 totally different tablets. One of those ought to give you the results you want, but when not, utilizing condoms plus spermicide is 97% efficient in stopping being pregnant.


“Do you need to be on birth control before you have sex for the first time or is a condom enough to prevent pregnancy?” — OliviaR821

Dr. Yen: “It depends how bad getting pregnant would be to you. I advise everyone with a uterus who is not trying to get pregnant to use condoms PLUS a hormonal method or copper IUD to avoid pregnancy.”


“I take birth control pills so that I can skip my periods (which are pretty debilitating) but I’m pretty bad at taking them regularly so I always need a secondary contraceptive. Could an IUD mean that I still get no periods or at least easier ones?” —RachelDiz

Dr. Yen: “You might want to try the IUD with hormone. 19–37% of women on the regular strength IUD with hormone lose their periods. And the rest get easier/lighter ones. You could also use the birth control ring (Nuvaring) for that. And there is a new vaginal ring Annovera which could be used for up to 1 year.”


“Is it normal for my acne to seem to get worse after starting the pill? (I’m taking the one with estrogen and progestin.)” —madelynf487f41e0c

Dr. Yen: Going on the capsule modifications up your hormones. Sometimes it takes 1–three months to get used to the hormones after which issues to relax. Theoretically, all contraception tablets ought to assist with zits. Sometimes it’s the hormone within the capsule that you simply have been prescribed. For zits we suggest much less androgenic progestins equivalent to norgestimate (in case you are not skipping bleeds), desogestrel (in case you are skipping bleeds) and drosperinone (if the opposite two don’t work and you’ll drink eight glasses of water a day). There are additionally a number of others you may strive.”


“Do you have to take the inactive pills? Or can you just skip taking pills for the week when you’re supposed to take them?” —madisonpaigearthur

Dr. Yen: You do NOT should take the inactive tablets. They are only a placeholder so that you don’t get out of shape taking your tablets 1 week out of four (25% of the time).”


“Within the past few months, I’ve started spotting while on a certain type of pill. Why would that start happening when I never had that problem before?” — PaopuFruitNoot

Dr. Yen: “If you have been on that pill awhile, then most likely it is because you have changed something else — for example, a supplement (which can affect absorption) or an over the counter cold medicine like pseudoephedrine or another medicine (which revs up your liver and chews through hormones more). Other things that might cause spotting are a polyp, a sexually transmitted infection causing your cervix to be friable (easy to be irritated and bleed), or weight gain/loss.”


“Do you ovulate while on the pill?” —sarahm46a7cbcdf

Dr. Yen: “The pill works by preventing ovulation, thinning your endometrium, causing a cervical mucus plug (with progesterone). However, some people may ovulate on the pill, especially heavier people, because the pill was made for a “standard weight” and the dose is probably not adequate to dam ovulation at days 5–7 of the capsule on the placebo/sugar capsule/bleeding week. At Pandia Health we suggest girls both #SkipTheBleed or solely be off for five days most and possibly four in case your BMI is >26.”


“Do you still ovulate with an IUD?” —courtneyjok

Dr. Yen: “With the copper IUD, sure. With the IUD with hormone, 65% of girls nonetheless do. And in case you are on the “lower hormone” IUD, then you definitely’re extra prone to have extra ovulation given the decrease hormone.”


“Is it true that oral contraceptives can give you symptoms of depression?” —TessMess01

Dr. Yen: “Recent studies indicate that women who do not suffer from PMDD-induced depression symptoms are at a slight increase of depression when taking certain hormonal forms of birth control. Although the risk of depression is increased for all types of hormonal birth control, the chance is incredibly small. Because studies in this arena are new and the science behind it emerging, there is no conclusive data on who is most susceptible to this increased risk yet.”


“I think my birth control gives me cramps outside of my period. Like, painful sharp pain in my pelvic area completely outside of my menstrual cycle — is this possible?” —rebeccan4bb72d040

Dr. Yen: “This is most likely NOT from the birth control. It is more likely from ovulation pain, endometriosis, or something else. Birth control stabilizes and calms things down. Sharp pain is not an aspect of birth control — dull cyclical pain, possibly — but sharp recurrent pain, no.”


“What are the failure rates of having your tubes tied vs. a vasectomy? Which one is more painful or has longer recovery time?” —speaktruthnoharm

Dr. Yen: “Vasectomy beats tubal ligation (i.e. getting your “tubes tied”) in efficacy. It is 3x as effective as tubal ligation in typical use and is far less invasive. Getting to the fallopian tubes you go through the abdomen (which has many layers of muscle) and is much more invasive. Also, with tubal ligation, there are far more risks, it’s far more costly, and the side effects are far more serious.”


“Can birth control help with regulating hormones from a low-functioning thyroid?” —Courtiepaigee

Dr. Yen: “You need to treat the thyroid problem. But you can use birth control hormonal methods with thyroid medication.”


“I’ve had an IUD for almost 5 years and it’s about time to change it. I’ve recently been wondering if there’s any long term effects I should be concerned about?” —gej617

Dr. Yen: “There are no long term effects known from having an IUD in for 5 years. And it is ‘known’ that having an IUD does not affect your future fertility.”


“How uncomfortable is it really to get an IUD inserted or removed? It doesn’t seem like it would be all that pleasant to get it inserted or removed so I’m a bit wary of it.” —b49a5393c6

Dr. Yen: “Each person is different and it depends on how you ‘feel’ your monthly cramps compared to another person with a uterus. It also depends on if you are on your period or not when you get it done or whether your provider uses a paracervical block or not. Generally, I advise women to get it on their period. NOT the first day but the last days — so, like, days 4–5 of bleeding. I also suggest to premedicate with 600 mg of ibuprofen with food 30 minutes to one hour ahead of time. Bring a heat pad, some music to distract you. Ask for the paracervical block. “


“I was told combination birth control shouldn’t be taken by people who have migraines with aura. Why? What are the risks?” —OMGitsaClaire

Dr. Yen: This is appropriate. You threat blood clots in your head and thus strokes and dying. The CDC has labeled migraines with aura as class four! This is a well being threat and this technique shouldn’t for use.


“Can birth control help with your period? Like make it lighter and make your cramps go away? I have the heaviest flow, I have to keep changing pads every hour or two, also my cramps are the worst where i can’t eat or move that much.” —merp626

Dr. Yen: “You should get checked for a bleeding disorder. That’s a lot of blood. And get checked for anemia, too! Von Willebrand’s Disease is the most common bleeding disorder and often shows up this way — lots of bleeding with the first period or overall.”


“Can IUDs “travel” by way of your physique?” —isabelamogo

Dr. Yen: “They could theoretically perforate through the uterus into the abdomen and then stick into your bladder or intestine. They used to think that it ‘wandered there’ but most likely it’s from insertion and provider error.”


“Is it normal for birth control to cause a lot of white discharge?” —nachocheez

Dr. Yen: That is likely to be Bacterial Vaginosis, which isn’t a problem except it bothers you or you might be pregnant and have a historical past of preterm births. BV is extra prone to be introduced on by month-to-month hormonal modifications, overseas our bodies (e.g. penis, condoms, intercourse toys), douche, or oral intercourse. See your supplier to get it checked. They can see if it’s regular or irregular if they’ve a microscope of their workplace. (Not all medical doctors have the microscope).”


“Did taking birth control pills for 8 years or having a copper IUD for 7 years contribute to me now having severe endometriosis?” —profdaniella

Dr. Yen: “We don’t know what causes endometriosis exactly. But birth control pills are often a treatment for it. So it’s unlikely the birth control pills contributed to it. The copper IUD is known to have side effects of heavier periods and more cramps. So the heavier periods might exacerbate the endometriosis.”


“Would birth control affect me differently now that I’ve been in menopause for over a year?” —theKatherine

Dr. Yen: “If you are in menopause, you don’t need birth control.”


“I live in a country with limited pill options, but would still like to be able to control my cycle. Is there any way to take multiphase birth control to prevent or delay your period?” —megh6

Dr. Yen: “You ought to be capable of cease your durations with any estrogen/progesterone capsule. However some tablets is likely to be simpler than others. The ones with larger progestin impact work higher for skipping the month-to-month bleed.

To be taught extra about #PeriodsOptional and methods to use the contraception capsule or ring to skip or cease durations go right here.”


“My birth control has completely messed up my cycle. I never know when I’m going to get my period. Is that normal?” — alleycat93

Dr. Yen: “Are you on the Progesterone only pill, the implant, the IUD with hormone, or the shot? That happens often with progesterone only methods. With the estrogen containing methods — the ring, patch, pill — the bleeds can be under your control.”


“I’ve been on the pill for about 4 years now but I can’t help but notice the libido that came with it. I’ve been to two OB-GYNs and both have said to just pump up the foreplay, but it doesn’t really help. Should I be switched to a different type of birth control or is it the type of pill that I’m on?” —a42dffea4a

Dr. Yen: “If you are experiencing less libido, then there are 30+ formulations of the pill (with different levels of estrogen and 8 different types of progestins) that you can try that might be better with libido. In general, ones with a more androgenic effect have more libido. But they also might have more acne associated with it.”

Questions and responses have been edited for size and readability.

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